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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT01338649
Other study ID # Light Therapy in PD
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date November 2007
Est. completion date October 2012

Study information

Verified date February 2023
Source Northwestern University
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Study objectives are to determine the efficacy, safety and tolerability of bright light treatment in Parkinson's Disease (PD) patients with daytime sleepiness. Thirty PD patients will be enrolled and equally randomized to bright light or dim-red light treatment. Objective (actigraphy) and subjective (sleep logs/scales) sleep measures will be collected through the baseline and intervention phases of the study. The primary outcome measure will be the change in the Epworth Sleepiness Scale (ESS) comparing the bright light treatment with dim-red light treatment. Secondary outcome measures will include the Multiple Sleep Latency Test (MSLT), global Pittsburgh Sleep Quality Index (PSQI) score, Parkinson's Disease Sleep Scale (PDSS) score, and actigraphy measures. A variety of exploratory analyses will examine the effects of bright light treatment on fatigue, depression, quality of life, cognition, and motor disability. Hypothesis: Bright light exposure will diminish daytime sleepiness and improve night-time sleep in PD patients with daytime sleepiness.


Description:

See above.


Recruitment information / eligibility

Status Completed
Enrollment 27
Est. completion date October 2012
Est. primary completion date October 2012
Accepts healthy volunteers No
Gender All
Age group N/A and older
Eligibility Inclusion Criteria: 1. Diagnosis of idiopathic PD as defined by the United Kingdom Parkinson's Disease Society Brain Bank Criteria 2. Hoehn and Yahr stage of 2 to 4 in the "on" state 3. Excessive daytime sleepiness as defined by the Epworth Sleepiness Scale (ESS) score of greater than or equal to 12 points 4. Stable PD medication regimen for at least 4 weeks prior to study screening 5. Willing and able to give written informed consent Exclusion Criteria: 1. Atypical parkinsonian syndromes 2. Significant sleep disordered breathing (defined as an apnea-hypopnea index >15 events/hr of sleep on screening PSG) 3. Significant periodic limb movement disorder (defined as a PLM arousal index>10 events/hr of sleep on screening PSG) and REM sleep behavior disorder (based on the presence of both clinical symptomatology as well as intermittent loss of REM atonia on screening PSG) 4. Cognitive impairment indicated by the mini-mental status examination (MMSE) score of less than 24 5. Presence of depression defined as the Beck Depression Inventory (BDI) score >14 6. Untreated hallucinations or psychosis (drug-induced or spontaneous) 7. Use of hypno-sedative drugs for sleep or stimulants during the daytime 8. Use of antidepressants unless the patient has been on a stable dose for at least three months 9. Visual abnormalities that may interfere with light therapy, such as significant cataracts, narrow angle glaucoma or blindness 10. Travel through 2 time zones within 90 days prior to study screening

Study Design


Related Conditions & MeSH terms


Intervention

Device:
Bright Light Treatment (Sun Ray Sunbox SB-558)
Bright Light Treatment (Sun Ray Sunbox SB-558) using light intensity of 10,000 lux, administered during two 1 hour periods during the day.
Dim red light (Sun Ray Sunbox SB-558)
Dim red light box administered during two 1 hour periods during the day using

Locations

Country Name City State
United States Northwestern University Chicago Illinois

Sponsors (2)

Lead Sponsor Collaborator
Northwestern University National Parkinson Foundation

Country where clinical trial is conducted

United States, 

References & Publications (34)

Adler CH, Caviness JN, Hentz JG, Lind M, Tiede J. Randomized trial of modafinil for treating subjective daytime sleepiness in patients with Parkinson's disease. Mov Disord. 2003 Mar;18(3):287-293. doi: 10.1002/mds.10390. — View Citation

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Ancoli-Israel S, Martin JL, Gehrman P, Shochat T, Corey-Bloom J, Marler M, Nolan S, Levi L. Effect of light on agitation in institutionalized patients with severe Alzheimer disease. Am J Geriatr Psychiatry. 2003 Mar-Apr;11(2):194-203. — View Citation

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Dhawan V, Healy DG, Pal S, Chaudhuri KR. Sleep-related problems of Parkinson's disease. Age Ageing. 2006 May;35(3):220-8. doi: 10.1093/ageing/afj087. — View Citation

Dijk DJ, Lockley SW. Integration of human sleep-wake regulation and circadian rhythmicity. J Appl Physiol (1985). 2002 Feb;92(2):852-62. doi: 10.1152/japplphysiol.00924.2001. — View Citation

Dowling GA, Hubbard EM, Mastick J, Luxenberg JS, Burr RL, Van Someren EJ. Effect of morning bright light treatment for rest-activity disruption in institutionalized patients with severe Alzheimer's disease. Int Psychogeriatr. 2005 Jun;17(2):221-36. doi: 10.1017/s1041610205001584. — View Citation

Dowling GA, Mastick J, Hubbard EM, Luxenberg JS, Burr RL. Effect of timed bright light treatment for rest-activity disruption in institutionalized patients with Alzheimer's disease. Int J Geriatr Psychiatry. 2005 Aug;20(8):738-43. doi: 10.1002/gps.1352. — View Citation

Factor SA, McAlarney T, Sanchez-Ramos JR, Weiner WJ. Sleep disorders and sleep effect in Parkinson's disease. Mov Disord. 1990;5(4):280-5. doi: 10.1002/mds.870050404. — View Citation

Fetveit A, Bjorvatn B. Bright-light treatment reduces actigraphic-measured daytime sleep in nursing home patients with dementia: a pilot study. Am J Geriatr Psychiatry. 2005 May;13(5):420-3. doi: 10.1176/appi.ajgp.13.5.420. — View Citation

Kaida K, Takahashi M, Haratani T, Otsuka Y, Fukasawa K, Nakata A. Indoor exposure to natural bright light prevents afternoon sleepiness. Sleep. 2006 Apr;29(4):462-9. doi: 10.1093/sleep/29.4.462. — View Citation

Karlsen KH, Tandberg E, Arsland D, Larsen JP. Health related quality of life in Parkinson's disease: a prospective longitudinal study. J Neurol Neurosurg Psychiatry. 2000 Nov;69(5):584-9. doi: 10.1136/jnnp.69.5.584. — View Citation

Klerman EB, Duffy JF, Dijk DJ, Czeisler CA. Circadian phase resetting in older people by ocular bright light exposure. J Investig Med. 2001 Jan;49(1):30-40. doi: 10.2310/6650.2001.34088. — View Citation

Kobayashi R, Kohsaka M, Fukuda N, Sakakibara S, Honma H, Koyama T. Effects of morning bright light on sleep in healthy elderly women. Psychiatry Clin Neurosci. 1999 Apr;53(2):237-8. doi: 10.1046/j.1440-1819.1999.00486.x. — View Citation

Kogan AO, Guilford PM. Side effects of short-term 10,000-lux light therapy. Am J Psychiatry. 1998 Feb;155(2):293-4. doi: 10.1176/ajp.155.2.293. — View Citation

Lees AJ, Blackburn NA, Campbell VL. The nighttime problems of Parkinson's disease. Clin Neuropharmacol. 1988 Dec;11(6):512-9. doi: 10.1097/00002826-198812000-00004. — View Citation

Lockley SW, Skene DJ, Arendt J, Tabandeh H, Bird AC, Defrance R. Relationship between melatonin rhythms and visual loss in the blind. J Clin Endocrinol Metab. 1997 Nov;82(11):3763-70. doi: 10.1210/jcem.82.11.4355. — View Citation

Meindorfner C, Korner Y, Moller JC, Stiasny-Kolster K, Oertel WH, Kruger HP. Driving in Parkinson's disease: mobility, accidents, and sudden onset of sleep at the wheel. Mov Disord. 2005 Jul;20(7):832-42. doi: 10.1002/mds.20412. — View Citation

Mishima K, Okawa M, Shimizu T, Hishikawa Y. Diminished melatonin secretion in the elderly caused by insufficient environmental illumination. J Clin Endocrinol Metab. 2001 Jan;86(1):129-34. doi: 10.1210/jcem.86.1.7097. — View Citation

Moore RY, Eichler VB. Loss of a circadian adrenal corticosterone rhythm following suprachiasmatic lesions in the rat. Brain Res. 1972 Jul 13;42(1):201-6. doi: 10.1016/0006-8993(72)90054-6. No abstract available. — View Citation

Moore-Ede MC, Czeisler CA, Richardson GS. Circadian timekeeping in health and disease. Part 2. Clinical implications of circadian rhythmicity. N Engl J Med. 1983 Sep 1;309(9):530-6. doi: 10.1056/NEJM198309013090905. No abstract available. — View Citation

Myers BL, Badia P. Changes in circadian rhythms and sleep quality with aging: mechanisms and interventions. Neurosci Biobehav Rev. 1995 Winter;19(4):553-71. doi: 10.1016/0149-7634(95)00018-6. Erratum In: Neurosci Biobehav Rev 1996 Summer;20(2):I-IV. — View Citation

Paus S, Brecht HM, Koster J, Seeger G, Klockgether T, Wullner U. Sleep attacks, daytime sleepiness, and dopamine agonists in Parkinson's disease. Mov Disord. 2003 Jun;18(6):659-67. doi: 10.1002/mds.10417. — View Citation

Phipps-Nelson J, Redman JR, Dijk DJ, Rajaratnam SM. Daytime exposure to bright light, as compared to dim light, decreases sleepiness and improves psychomotor vigilance performance. Sleep. 2003 Sep;26(6):695-700. doi: 10.1093/sleep/26.6.695. — View Citation

Reid KJ, Burgess HJ. Circadian rhythm sleep disorders. Prim Care. 2005 Jun;32(2):449-73. doi: 10.1016/j.pop.2005.02.002. — View Citation

Rye DB, Bliwise DL, Dihenia B, Gurecki P. FAST TRACK: daytime sleepiness in Parkinson's disease. J Sleep Res. 2000 Mar;9(1):63-9. doi: 10.1046/j.1365-2869.2000.00201.x. — View Citation

Scaravilli T, Gasparoli E, Rinaldi F, Polesello G, Bracco F. Health-related quality of life and sleep disorders in Parkinson's disease. Neurol Sci. 2003 Oct;24(3):209-10. doi: 10.1007/s10072-003-0134-y. — View Citation

Schindler SD, Graf A, Fischer P, Tolk A, Kasper S. Paranoid delusions and hallucinations and bright light therapy in Alzheimer's disease. Int J Geriatr Psychiatry. 2002 Nov;17(11):1071-2. doi: 10.1002/gps.497. — View Citation

Shochat T, Martin J, Marler M, Ancoli-Israel S. Illumination levels in nursing home patients: effects on sleep and activity rhythms. J Sleep Res. 2000 Dec;9(4):373-9. doi: 10.1046/j.1365-2869.2000.00221.x. — View Citation

Stocchi F, Barbato L, Nordera G, Berardelli A, Ruggieri S. Sleep disorders in Parkinson's disease. J Neurol. 1998 May;245 Suppl 1:S15-8. doi: 10.1007/pl00007731. — View Citation

Tandberg E, Larsen JP, Karlsen K. A community-based study of sleep disorders in patients with Parkinson's disease. Mov Disord. 1998 Nov;13(6):895-9. doi: 10.1002/mds.870130606. — View Citation

Van Someren EJ, Riemersma RF, Swaab DF. Functional plasticity of the circadian timing system in old age: light exposure. Prog Brain Res. 2002;138:205-31. doi: 10.1016/S0079-6123(02)38080-4. No abstract available. — View Citation

Wever RA, Polasek J, Wildgruber CM. Bright light affects human circadian rhythms. Pflugers Arch. 1983 Jan;396(1):85-7. doi: 10.1007/BF00584704. — View Citation

* Note: There are 34 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Change in the Epworth Sleepiness Scale (ESS) Scores Comparing the Bright Light Exposure With Dim-red Light Exposure. ESS score range is 0-24; lower ESS scores indicate less daytime sleepiness; higher ESS scores indicate more severe sleepiness ESS will be taken and compared at screening and week 4 visits between the bright light exposure and dim-red light exposure groups. baseline and 4 weeks
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